CC March 2016 Reye's Syndrome

echoecho's version from 2016-05-09 04:23


Question Answer
Define Reye's syndrome?it is an extremely rare condition that results from mitochondrial injury in a virus-infected host who has been sensitized by a mitochondrial toxin, most often a salicylate
List the 3 cells that seem to be particularly sensitive to this combination?1) nuerons 2) hepatocytes 3) nephrons
First described in 1963, this syndrome was designated as a reportable illness in the US in what year?1973
Although < 1% of children who took salicylates developed Reye's syndrome, more than ____% of children with Reye's syndrome had consumed salicylates in the previous 3 weeks?80%
The peak incidence of Reye's syndrome in the US was 555 cases what year?1979-1980
The incidence fell dramatically following a warning from the FDA about what?the association between salicylates and Reye's syndrome
Although no longer a reportable disease, there have been about ___ cases of Reye's syndrome annually over the past 20 years?2
*** The American Academy of Pediatrics and the Centers for Disease Control and Prevention (CDC) recommend avoiding using ASA for fever- causing illnesses in children < ___ years?19
List the most common viral triggers?1) Influenza (types A and B) 2) varicella zoster virus
List other pathogens that have been implicated for viral triggers?1) adenovirus 2) measles 3) cytomegalovirus 4) Epstein-Barr virus 5) coxsackievirus 6) HIV
Although salicylates are the most common mitochondrial toxin, list other medications that have been implicated?1) warfarin 2) valproic acid (Depakote) 3) diclofenac (Voltaren) 4) other occupational exposures from herbicides or insecticides
True or False? Some inborn erros of metabolism have also produced symptoms similar to Reye's syndrome?true
What typically occurs suddenly several hours to weeks (mean, 3 days) after resolution of the viral syndrome?vomiting
One to two days after vomiting, what symptoms will occur?1) lethargy 2) irritability 3) restlessness
Is fever present?no
What % of children will have hepatomegaly?50
Lab abnormalities reflect the degree of _____ dysfunction? List these?1) hepatic 2) elevations of ammonia 3) elevation of transaminase levels 4) prothrombin time and PTT
Mild hyperbilirubinemia may also be present, although are marked elevations common?no
True of false? Lumbar punctures is nondiagnostic?true
True or false? CT scan of the head is nondiagnostic?true
*** True or false? No combinations of lab studies are diagnostic for Reye's syndrometrue
What is the treatment?No specific treatment but delirium, seizures, coma and death may occur. Supportive rx (fluid support, admission to a ICU for for hemodynamic monitoring and prevention of hypoglycemia
Consultation with what 2 specialist may be needed?Neurology and GI
Seizures should be treated with what?1) antiepileptic drugs 2) increased intracranial pressure aggressively man
Even with aggresive management, the case fatality rate is what?10-40
*** SUMMARY = Clincal presentation is suddenly onset of ______ following resolution of a viral syndrome, followed by what 3 symptoms?lethargy, irritabilty and restlessness. Fever is absent
*** SUMMARY = What is the treatment?supportive but aggressive
*** SUMMARY = The fatality rate is ____ to ___% even with treatment?10-40%